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Tuberculosis (TB) in certain
communities of Chicago continues to pose a potential threat
for re-emergence. In fact, there are 14 communities in Chicago
that continue to have TB rates that are higher than the national
and local rates. The majority of these communities are on
the south side of Chicago; some of these communities are Grand
Boulevard, Englewood, South Shore, and Roseland.
The Metropolitan Chicago
Tuberculosis Coalition of the American Lung Association (MCTC),
which emerged from the work of the Chicago Department of Health
(CDPH)/ Cook County Tuberculosis Task Force, was established
in 1992 to address the re-emergence of the tuberculosis (TB)
epidemic in the late 1980’s. MCTC was comprised of representatives
from public medicine, public health and private entities.
Taking its lead from the
Centers for Disease Control (CDC) in Atlanta, Georgia and
its principles espoused by international agencies for tuberculosis
elimination, MCTC set about the business of oversight for
TB control in metropolitan Chicago. Led by some of the most
noted infection control, pulmonology and public health experts
in the area, the TB problem in Chicago over the past decade
has been greatly impacted, with significant declines in TB
rates. In spite of these efforts, a community health risk
remains.
The goal of MCTC is to continue
to create, coordinate and mobilize a variety of resources
to focus on the elimination of TB in Chicago and metropolitan
Chicago. With this in mind, two years ago, MCTC began hosting
a series of community symposiums.
The ultimate desire was to
“keep TB on the radar screen” in order to avoid
another epidemic. A variety of community-based organizations
were invited to come together to plan strategies to support
MCTC and CDPH in its continuing efforts. Such agencies included
churches, homeless shelters, local health and social service
providers, as well as forums held by consumers and elected
officials. After the South Side symposiums held in Grand Boulevard,
additional symposiums were held on the west side and north
side of Chicago. All planning groups are actively addressing
the TB problems within their jurisdictions.
Aldermen Ed Smith and Arenda
Troutman took the political lead and greatly increased MCTC’s
ability to access the affected communities. The HIV community
has also greatly supported the community efforts of MCTC,
including funding support. The South Side efforts have received
support from the administration staff at St. Bernard and South
Shore hospital through meeting space and infection control
nurses support.
How TB works
Unlike some other communicable
diseases where person-to-person physical contact is needed
to acquire the disease, TB is an airborne illness, which may
be contracted when one breathes the same air of an active
contagious case for prolonged periods. With HIV, for instance,
one can choose their sexual partner. That’s unlike TB,
where one is not always aware of the air space they’re
sharing.
TB is contracted when one
shares the air space with an active infectious person who
is talking, coughing, singing or otherwise exhaling germs
into the environment. Most persons who come into contact with
an active case will not develop one themselves, but may develop
a latent form of the disease of the disease called latent
TB. Of those who develop the latent form of the disease, approximately
10% will develop active disease later in life.
Those persons with impaired
immune systems which occurs with HIV/AIDS, diabetes, cancer
chemotherapy and other susceptible conditions are more likely
to develop the active form of the disease. Once someone has
active TB, they will require a minimum of six months of treatment
or more, depending on whether they contract a drug resistant
form or if they have an immune-compromised disorder. Those
with latent TB can avoid an active case later in life by taking
treatment.
Prevention
There are some preventive
measures that everyone can take for TB control and some of
these include:
- Covering one’s mouth and
nose when coughing (keeping tissue handy in your place of
business).
- Recognizing the signs and symptoms,
which include: a cough lasting more than two weeks, weight
loss, night sweats, loss of appetite and bloody sputum.
Anyone with these symptoms should have a medical work up
for TB.
- Annual TB screening.
- Assuring that there is a TB
screening program in your work place for clients and staff.
TB rates are found to be
higher in some risk groups, such as those with HIV/AIDS, intravenous
drug users, the medically compromised, the incarcerated and
in some foreign-born populations. While one may argue that
they have little contact with persons listed, please bear
in mind that TB is airborne and individuals in these groups
are mobile and so TB remains a public health risk. Speaking
of the incarcerated, in 1992 in New York City, more than 30
inmates and two correctional officers died from a drug resistant
from of TB.
If you would like to have
more information about TB, including a TB 101 course for your
staff, please contact Judith Beison, coordinator of TB programs
at the American Lung Association, at (312) 243-2000.
Dorothy Murphy is co-chair
of the Metropolitan Chicago Tuberculosis Coalition of the
American Lung Association.
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